Sex differences in the management of patients with acute coronary syndrome: A population-based ecological cross-sectional study in Spain
Abstract Introduction and objectives Despite evidence of a reduction in the incidence and mortality of acute coronary syndrome (ACS), some studies have highlighted differences in outcomes between men and women. We aimed to explore sex differences in the management and treatment of patients with ACS in Spain. Methods This ecological cross-sectional study combined ACS data from 10 Spanish registries (54 centres). Meta-regression analysis was performed using aggregated data of baseline characteristics, interventional procedures, treatments, and events that occurred during hospitalization and one-year follow-up. Results Aggregated data from 34 605 patients (75.1% men) was included. ST-segment e…
Tendencias temporales en comunicación interventricular posinfarto: resultados del registro CIVIAM
Resumen Introduccion y objetivos La rotura de septo interventricular tras un infarto es una complicacion rara, pero muy grave, con una alta tasa de mortalidad. Nuestro proposito es analizar que factores han podido influir en la mortalidad por esta afeccion durante la ultima decada, incluyendo los relacionados con la asistencia circulatoria mecanica. Metodos El registro CIVIAM es un estudio retrospectivo, observacional y multicentrico desarrollado en Espana. Se diseno un analisis comparativo, cuyos objetivos primarios son describir el tratamiento de esta afeccion, asi como los cambios en la mortalidad hospitalaria y al ano, dividiendo el periodo de observacion en 2 periodos iguales (enero de…
Antithrombotic Therapy in Elderly Patients with Acute Coronary Syndromes
The treatment of acute coronary syndrome (ACS) in elderly patients continues to be a challenge because of the characteS.G.B.ristics of this population and the lack of data and specific recommendations. This review summarizes the current evidence about critical points of oral antithrombotic therapy in elderly patients. To this end, we discuss the peculiarities and differences reported referring to dual antiplatelet therapy (DAPT) in ACS management in elderly patients and what might be the best option considering these population characteristics. Furthermore, we analyze antithrombotic strategies in patients with atrial fibrillation (AF), with a particular focus on those cases that also presen…
Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years. The primary end point was one-year all-cause mortality. A total of 7211 patients were included, 2,770 (38.4%) were women, and 39.9% had DM. Compared with the men, the women were older (79.95 ± 5.75 vs. 78.45 ± 5.43 years, p <
Frequency of Renal Dysfunction and Frailty in Patients ≥80 Years of Age With Acute Coronary Syndromes.
While a significant association between renal function and outcomes in patients with acute coronary syndromes (ACS) has been consistently described, little information exists about the magnitude of this association in patients at older ages. No study assessed the prognostic role of renal function according to frailty in patients with ACS. The LONGEVO-SCA registry included unselected ACS patients aged≥80 years. Frailty was asessesed by the FRAIL scale, and baseline creatinine clearance was calculated by the Cockroff-Gault formula. We evaluated the impact of renal function on mortality or readmission at 6-months according to frailty status by the Cox regression method. A total of 473 patients…
Temporal trends in postinfarction ventricular septal rupture: the CIVIAM Registry
Abstract Introduction and objectives Postinfarction ventricular septal rupture is a rare but severe complication of myocardial infarction with high mortality rates. Our goal was to analyze which factors could have an impact on mortality due to this entity over the past decade, including those related to mechanical circulatory support . Methods The CIVIAM registry is an observational, retrospective, multicenter study carried out in Spain. We designed a comparative analysis, focused on description of in-hospital management and in-hospital and 1-year total mortality as the primary endpoints, dividing the total observation time into 2 equal temporal periods (January 2008 to June2013 and July 20…